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https://hdl.handle.net/2440/105707
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dc.contributor.author | Radhakutty, A. | - |
dc.contributor.author | Mangelsdorf, B. | - |
dc.contributor.author | Drake, S. | - |
dc.contributor.author | Samocha-Bonet, D. | - |
dc.contributor.author | Jenkins, A. | - |
dc.contributor.author | Heilbronn, L. | - |
dc.contributor.author | Smith, M. | - |
dc.contributor.author | Thompson, C. | - |
dc.contributor.author | Burt, M. | - |
dc.date.issued | 2016 | - |
dc.identifier.citation | Clinical Endocrinology, 2016; 84(4):501-508 | - |
dc.identifier.issn | 0300-0664 | - |
dc.identifier.issn | 1365-2265 | - |
dc.identifier.uri | http://hdl.handle.net/2440/105707 | - |
dc.description.abstract | Objective: Postprandial hyperglycaemia is associated with increased arterial stiffness and cardiovascular events. Low-dose prednisolone causes insulin resistance that typically manifests as postprandial hyperglycaemia. We investigated whether prednisolone causes postprandial vascular dysfunction in a cohort of patients with rheumatoid arthritis. Design: An open interventional and cross-sectional study was undertaken. Patients and measurements: Eighteen subjects with rheumatoid arthritis who had not taken oral glucocorticoids for ≥6 months were studied before and after prednisolone 6 mg/day for 7 days to determine the acute effects of prednisolone. Pre-prednisolone data were compared to 18 subjects with rheumatoid arthritis taking long-term (>6 months) prednisolone (6·5 ± 1·8 mg/day) to assess the chronic effects of prednisolone. Augmentation index (by applanation tonometry) and reactive hyperaemia index (by peripheral artery tonometry) were measured before and after a mixed-meal (10 kcal/kg, 45% carbohydrate, 15% protein, 40% fat). Insulin sensitivity was estimated by the Matsuda index and sympathetic nervous system activity from urinary noradrenaline excretion. Results: Matsuda index was lower after acute (2·0 ± 1·0 vs 3·6 ± 1·1, P = 0·01) and chronic (1·9 ± 1·0 vs 3·6 ± 1·1, P = 0·04) prednisolone. Postprandial augmentation index was lower after acute prednisolone (2551 ± 197 vs 2690 ± 272%*min, P ≤ 0·001), but not chronic prednisolone. There were no significant differences in reactive hyperaemia index with acute or chronic prednisolone. Noradrenaline excretion was lower after acute (54 ± 8 vs 93 ± 23 nmol/6 h, P = 0·02), but not chronic, prednisolone. Conclusions: Prednisolone-induced insulin resistance is not associated with postprandial vascular dysfunction in patients with rheumatoid arthritis. Reduced sympathetic activity may contribute to the reduction in postprandial arterial stiffness with acute prednisolone. | - |
dc.description.statementofresponsibility | Anjana Radhakutty, Brenda L. Mangelsdorf, Sophie M. Drake, Dorit Samocha-Bonet, Arthur B. Jenkins, Leonie K. Heilbronn, Malcolm D. Smith, Campbell H. Thompson and Morton G. Burt | - |
dc.language.iso | en | - |
dc.publisher | Blackwell Publishing | - |
dc.rights | © 2015 John Wiley & Sons Ltd | - |
dc.source.uri | http://dx.doi.org/10.1111/cen.12966 | - |
dc.subject | Arthritis, Rheumatoid | - |
dc.title | Effect of acute and chronic glucocorticoid therapy on insulin sensitivity and postprandial vascular function | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1111/cen.12966 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Heilbronn, L. [0000-0003-2106-7303] | - |
dc.identifier.orcid | Thompson, C. [0000-0002-5164-3327] | - |
Appears in Collections: | Aurora harvest 8 Molecular and Biomedical Science publications |
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